Psychic Fallout from Breach of Confidentiality

Burka, Jane

doi:10.1080/00107530.2008.10747146

Cited by 16 publications

(6 citation statements)

References 18 publications

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“…Since the first analytic students were graduated we have assumed that training analysis provides some sort of counterbalance, at least to the more extreme potentialities of unconsciously based analytic action. Yet we are painfully aware that analysts rigorously trained in the modern system of international standards, training analysis, certification, and ethical awareness have not only had fantasies and desires in the treatment situation but have acted on them in massively destructive ways (Burka, 2008). Could a more active recognition and self-searching study, both individually and within psychoanalytic organizations, provide some buffer to these effects?…”

Section: Discussionmentioning

confidence: 99%

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Patients’ Pregnancies During Treatment: The Influence of the Analyst’s Psychology

Almond

2015

Psychoanalytic Dialogues

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Psychoanalytic therapists are today far more aware of countertransference effects, intersubjectivity, and mutual influence. The area that has been explored least in this two-person appreciation of psychoanalytic process is the effect of the psychodynamics of the therapist in a wide sense-that is, how the therapist brings a whole psychology, with a wide array of potential transferences, to each treatment. Triggered by the unexpected announcement of a patient's expecting a baby, the author reviewed his practice and found that a large portion of his women patients ages 30-45 had become pregnant during therapy or psychoanalysis. The particulars were varied: how much the patient wanted a baby, whether the treatment was psychotherapy or psychoanalysis, the patients' personality structure. Was the analyst's psychology a common factor? The paper presents three quite different case examples and examines whether and how the author's developmental and inner experience of women, sexuality, pregnancy could have contributed to a dyadic process that, in turn, could lead to pregnancy. If such effects happen, then it is important to look beyond and behind "anonymity" and "neutrality," as well as momentary countertransferences, to the real-life effects that we have in our treatments.In the course of 40 years of clinical work I have, naturally, seen quite a few women in the child-bearing years. My subjective sense, looking back, is that a disproportionate number of these women have gotten pregnant. 1 The individual situations are tremendously varied, and there is no way to prove my assertion of "disproportionate." Even if there have been an unusually large number of pregnancies, basing this impression on the experience of one analyst makes it impossible to know whether this is simply a statistical aberration, or, on the other hand, whether it is unremarkable, typical for the age range of my particular population of women patients. In this paper I ask the reader to accept the possibility that this was unusual. Was I the common factor? Could I be working, interacting with women patients in some way that made pregnancy likely? 1 A very rough review of my practice suggests that more than one third of the patients in the possible group got pregnant during treatment, and another third had a child subsequently (letting me know), for a total of two thirds of the total. My impression is also that this proportion increased to roughly half, as my practice continued, and I saw more women in the latter part of the child-bearing years (ages 30-45). As a baseline comparison, the average child-bearing rate for the age group 30-45 in recent years is 5.5%/year. If my treatment contacts averaged 5 years in length, the "control group" rate would be 28%. My patient population tended to be in the 35-to 45-year-old range, where the "control" rate would be 17%.Correspondence should be addressed to Richard Almond, M.D.,

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Section: Discussionmentioning

confidence: 99%

“…We are better off if we consider its possible clinical impacts. Excessive anxiety and self-protectiveness about analyst influence discourages examination, which then tends to be limited to after-the-fact inquests into extreme boundary-crossing(Burka, 2008;Celenza & Gabbard, 2003).…”

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confidence: 98%

Patients’ Pregnancies During Treatment: The Influence of the Analyst’s Psychology

Almond

2015

Psychoanalytic Dialogues

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“…Given that now, as opposed to then, we can talk about the primal crime-the conversation has already begun (e.g., Burka, 2008;Celenza, 2007;Cornell, 2009;Dimen, 2011;Gabbard, 1989)-I want to return to the essay's ostensive topics-sex and technique-and ask, rhetorically: Is there any technique to help us with the problem of sexual boundary violations? Short answer: No.…”

Section: But What About Sexual Boundary Violations?mentioning

confidence: 97%

Inside the Revolution: Power, Sex, and Technique in Freud’s “‘Wild’ Analysis”

Dimen

2014

Psychoanalytic Dialogues

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“…Moreover, even with a stated principle of confidentiality inviolate, its actual fact may only be determined between participants in lived relation to each other, for trust can no more be legislated than respect or love, but instead must be deservedly established within each and every interpersonal context. Furthermore, as Celenza and Gabbard (2003) have detailed, egregious violations of even the formally designated clinical psychoanalytic frame between analysts and patients do occur; and the designation of these formally sanctioned clinical situations as personal or training analyses provide no absolute remedy to such potential transgressions (Burka, 2008).…”

Section: Personal Experiencementioning

confidence: 99%

On the Experiential and Psychotherapeutic Dimensions of Psychoanalytic Supervision: An Interpersonal Perspective

Zicht¹

2013

Am J Psychoanal

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I advocate in this article for supervision to provide a frankly psychoanalytic (i.e. psychotherapeutic) experiential encounter for the supervisee, and the stipulation that it convey experientially the very idiom it is intending to impart. I contend that the psychotherapeutic and experiential potentials of psychoanalytic supervision have often been prescriptively delimited, to the detriment of its participants' potential transformations and evolutions as psychoanalysts and persons. I address some of the unique contributions interpersonal psychoanalytic theories offer in support of conducting psychoanalytic supervision in terms of my suggested modifications.

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Psychic Fallout from Breach of Confidentiality

Cited by 16 publications

References 18 publications

Patients’ Pregnancies During Treatment: The Influence of the Analyst’s Psychology

Patients’ Pregnancies During Treatment: The Influence of the Analyst’s Psychology

Inside the Revolution: Power, Sex, and Technique in Freud’s “‘Wild’ Analysis”

On the Experiential and Psychotherapeutic Dimensions of Psychoanalytic Supervision: An Interpersonal Perspective

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